Nutrition and infection in tropical countries--implications for public health intervention--a personal perspective

Although the health and nutritional status of populations in many countries in the tropical and subtropical zones in Africa, Latin America, and Asia have improved considerably, nutritional problems and the burden of infectious diseases are still a major public health concern. This review presents the interrelationship between infections and the nutritional status of preschool children with an emphasis on "protein-energy-deficiency" on a community basis. Common nutritional indicators of subclinical undernutrition are the proportion of underweight, wasting, and stunting in children. These anthropometric nutritional indicators are also proxy indicators of the overall well-being of the child population. They reflect, in particular, the burden of infectious diseases on the community. Also in subclinical undernutrition, infectious diseases and often ill-defined spells of illness negatively affect nutritional status. A reduced nutritional status increases the risk of infections. Infectious diseases and undernutrition interact synergistically. In most countries, available resources are adequate to improve the nutritional status of the population and reduce illness spells; that is, if the population could be motivated to take health-related actions and have the active support of the health delivery sector on a community level.